GENDER DIFFERENCES IN THE RELATIONSHIP OF PURINE AND THYROID EXCHANGE IN GOUT

  • Г. А. Игнатенко SEI HPE «M. Gorky Donetsk National Medical University», Donetsk
  • И. В. Мухин SEI HPE «M. Gorky Donetsk National Medical University», Donetsk
  • М. В. Присяжнюк Donetsk Clinical Territorial Medical Association, Donetsk
  • Ю. С. Паламарчук SEI HPE «M. Gorky Donetsk National Medical University», Donetsk
  • Н. Ю. Паниева SEI HPE «M. Gorky Donetsk National Medical University», Donetsk

Abstract

The aim of the work was to assess gender differences in the relationship between purine and thyroid metabolism in patients with primary gout and to develop strategic approaches to their correction in representatives of different sexes. The study included 130 patients with primary gout aged 48.9±0.56 years (109 men and 21 women). The state of purine metabolism in humans was assessed by the level of uric acid and oxypurinol in the blood, as well as their clearance values. The study of thyroid hormones was carried out by radioimmunoassay. The parameters of purine metabolism, pituitary and thyroid function were studied before treatment and 3 months after the start of hypouricemic therapy with allopurinol. In the course of the study, it was found that patients with gout have laboratory signs of moderate (in women) and subclinical (in men) hypothyroidism. Purine metabolism disorders in patients with gout with thyroid dysfunction are characterized by overproduction of purine bases with impaired elimination processes. Hypouricemic treatment with allopurinol resulted in a significant decrease in uricemia and an increase in urate clearance. The gender characteristics of the course of thyroid dysfunction in gout are characterized by a more intense suppression of the secretion of thyroid hormones in women and the predominance of the autoimmune component of inflammation in them with a weak reversal of changes in the course of treatment. In men, the course of thyroid syndrome was characterized by less intense inhibition of thyroid function and more intensive recovery of it against the background of hypouricemic treatment than in women. In men with gout, the nature of the course of hypothyroidism is secondary and largely reversible, whereas in women, the predominant mechanism for the formation of thyroid dysfunction is autoimmune thyroiditis, which requires additional prescription of thyroid replacement therapy.


Key words: gender differences, relationship between thyroid and purine metabolism, gout.

References

1. Ахмедов С.А. Гипотиреоз в практике терапевта. Терапевт. 2017; 12: 29-33.
2. Губанова Г.В., Беляева Ю.Н., Шеметова Г.Н. Гипотиреоз в общей врачебной практике: современный взгляд на проблему. Земский врач. 2015; 3 (27): 12-15.
3. Дедов И.И., Мельниченко Г.А., Фадеев В.В. Эндокринология. М.: ГЭОТАР-Медиа; 2009. 422.
4. Долгих Ю.А., Вербовой А.Ф., Шаронова Л.А. Субклинический гипотиреоз. Клиническая медицина. 2017; 2: 118-122.
5. Гончарова Е.С., Пестун Е.М., Пояркова А.И., Строев Ю.И., Чурилов Л.П. Мочевая кислота, подагра и аутоимунный тиреоидит: от Е.С. Лондона – до наших дней. Clin. Pathophisiol. 2018; 4: 56-67.
6. Игнатенко Г.А., Брыжатая Ю.О., Контовский Е.А., Мухин И.В. и др. Взаимоотношение клинического течения подагрического процесса с состоянием пуринового обмена у гипертензивных больных подагрой. Вестник неотложной и восстановительной хирургии. 2018; Т. 3, 4: 332-336.
7. Cooper D.S., Biondi B. Subclinical thyroid disease. Lancet. 2012; 379 (9821): 1142-1154.
8. Lin L.W., Teng G.G., Na A.Y., Lim et al. Cost‐effectiveness of an adherence‐enhancing intervention for gout based on real‐world data. Int. J. Rheum. Dis. 2019; 22 (4): 545-554.
9. Manji N., Carr-Smith J.D., Boelaert K. et al.Influences of age, gender, smoking and family history on autoimmune thyroid disease phenotype. J. Clin. Endocrinol. Metab. 2006; 12: 4873-4880.
10. Esfandiari N.H., Papaleontiou M. Biochemical Testing in Thyroid Disorders. Endocrinol. Metab. Clin. North Am. 2017; 46 (3): 631-648.
11. Groot L.De., Abalovich M., Alexander E.K. et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 2012; 97 (8): 2543-2565.
12. Perez-Ruiz F., Desideri G. Improving adherence to gout therapy: an expert review. Ther. Clin. Risk Manag. 2018; 14: 793-802.
13. Singh A.J., Cleveland J.D., Singh A.J. Gout and Hypothyroidism in the Elderly: an Observational Cohort Study Using U.S. Medicare Claims Data. J. Gen. Intern. Med. 2018; 33 (8): 1229-1231.
14. Redford C., Vaidya B. Subclinical hypothyroidism: Should we treat? Post. Reprod. Health. 2017; 23 (2): 55-62.
Published
2023-01-14
How to Cite
ИГНАТЕНКО, Г. А. et al. GENDER DIFFERENCES IN THE RELATIONSHIP OF PURINE AND THYROID EXCHANGE IN GOUT. University Clinic, [S.l.], n. 1(42), p. 5-12, jan. 2023. ISSN 1819-0464. Available at: <http://journal.dnmu.ru/index.php/UC/article/view/821>. Date accessed: 18 jan. 2026.
Citation Formats
Issue
No 1(42) (2022): UNIVERSITY CLINIC
Section
Оригинальные исследования